Endocervical curettage (ECC) is a procedure in which the mucous membrane of the cervical canal is scraped with a curette. In order to penetrate the endometrium, it is necessary to previously expand the cervix by means of cervical dilation.
Why Undergo Cervical Dilation and Endocervical Curettage (ECC)?
There are two main reasons for undergoing this procedure:
- removing excess tissue from the uterus after a recent pregnancy or abortion
- as part of the diagnostic procedure in women with irregular and abundant menstrual cycles, and vaginal bleeding in menopause
ECC after Abortion
During or after the abortion, the doctor will examine the pregnant woman to determine if there are any remains of the tissue in the uterus.
In this case, ultrasound is the best method for examining the uterus. Emptying the uterus is carried out in order to prevent abundant bleeding and eliminate the possibility of infection.
If the abortion occurred at an early stage of pregnancy or if there is only a small amount of remaining tissue in the uterus, surgery is not required – the excess tissue will be released with the next period.
Is There an Alternative to Cervical Dilation and Endocervical Curettage (ECC)?
There is an alternative that uses medications only. Pills stimulate contractions in the uterus which is then emptied. The success rate of the nonoperative method is somewhat lower, but this method steps in when for some reason it is not desirable to perform the operation.
What Does the Endocervical Curettage Procedure Look Like?
Since cervical dilation can be an uncomfortable and slightly painful procedure, nowadays it is usually performed under local anesthesia. Not many doctors will perform cervical dilation and ECC completely without anesthesia, and sometimes general anesthesia is used (e.g. in case the patient is very afraid of the procedure).
Having anesthetized the patient, the doctor performs cervical dilation. After that, the curette is drawn through the cervix to scrape the uterine mucous membrane in longitudinal movements. Sometimes vacuum aspiration is also used in the procedure. The tissue sample is then sent for analysis.
The whole procedure usually does not last longer than fifteen minutes.
Recovery After Endocervical Curettage
Most women are likely to recover from the procedure the following day. Rest is recommended on the day of the procedure; the following day, the patient can continue with her daily activities. Irregular bleeding is a normal occurrence for several days after the procedure.
ECC during Menopause
Sometimes bleeding can occur when it is not expected, e.g. between two periods or during sexual intercourse. Such changes may be caused by hormonal changes or disturbances in the uterine area.
Elderly women who experience bleeding during menopause are subjected to ECC in order to diagnose the disorder and to determine the treatment procedure.
Women under 40 rarely have uterine disorders.
Risks of Cervix Dilation and Endocervical Curettage
This procedure is very safe and goes without complications.
There is a possibility of ECC not being carried out completely so that part of the tissue remains in the uterus. In this case, it is normally not necessary to repeat the procedure because the excess tissue leaves the body by itself.